Organization
WISCONSIN DENTAL TEAM, A SERVICE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEJANDRA RIVERA (OWNER)
(813) 388-1553
Entity
Organization
Contact information
Practice address
805 N MAYFAIR RD, WAUWATOSA, WI 53226-4241
(414) 567-0662
(414) 249-6075
Mailing address
9709 LAKESIDE BLVD STE 350, SPRING, TX 77381-1213
(713) 489-2198
(713) 489-2978
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
01/30/2025
Last updated
06/20/2025
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